吻合血管的髂骨瓣植骨和锁定加压板固定治疗严重粉碎胫骨平台骨折临床疗效和安全性

Treatment of Shattered Tibial Plateau Fracture with Vascularized Iliac Bone Graft and Locking Compression Plate

目的：探讨了吻合血管的髂骨瓣植骨和锁定加压板固定治疗严重粉碎胫骨平台骨折临床疗效和安全性。方法：选取2011年7月-2012年12月我院收治的20例严重粉碎性胫骨平台骨折，采用吻合血管的髂骨瓣植骨及锁定加压板固定治疗，并观察治疗效果。结果：对20例患者随访12个月发现，患者骨折均达到愈合标准，且无患者出现内固定断裂、松动等现象。膝关节HSS评分手术治疗后12个月优良率达到了90%，效果显著。结论：吻合血管的髂骨瓣植骨大大的改善了骨折端的血运情况，同时还提供了有力的平台支撑，让患者在手术治疗后能尽早的进行功能锻炼，有利于促进骨质愈合，临床效果更加确实、可靠。

Objective： To evaluate the clinical efficacy of vascularized iliac bone graft and locking compression plate in the treatment of complex tibial plateau fracture. Methods：20 patients in our hospital from July 2011 to December 2012 with shattered tibial plateau fracture were treated with vascularized iliac bone graft and locking compression plate. Results：All patients were followed up for a mean duration of 12 months. No loosening or rupture of the fixator,or reduction failure was observed. According to HSS scoring,there was excellent in 14 cases,good in 4 cases and fair in 2 cases, with excellent and good rate of 90%.Conclusions：Vascularized iliac bone graft in the treatment of complex tibial plateau fracture can improve the blood supply and locking compression plate is an effective fixator due to its convenience and stability.The combined use of the two methods discussed above can achieve good clinical effects.